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Abstract
Bruxism is a controversial phenomenon. Both its definition and the diagnostic procedure
contribute to the fact that the literature about the aetiology of this disorder is
difficult to interpret. There is, however, consensus about the multifactorial nature
of the aetiology. Besides peripheral (morphological) factors, central (pathophysiological
and psychological) factors can be distinguished. In the past, morphological factors,
like occlusal discrepancies and the anatomy of the bony structures of the orofacial
region, have been considered the main causative factors for bruxism. Nowadays, these
factors play only a small role, if any. Recent focus is more on the pathophysiological
factors. For example, bruxism has been suggested to be part of a sleep arousal response.
In addition, bruxism appears to be modulated by various neurotransmitters in the central
nervous system. More specifically, disturbances in the central dopaminergic system
have been linked to bruxism. Further, factors like smoking, alcohol, drugs, diseases
and trauma may be involved in the bruxism aetiology. Psychological factors like stress
and personality are frequently mentioned in relation to bruxism as well. However,
research to these factors comes to equivocal results and needs further attention.
Taken all evidence together, bruxism appears to be mainly regulated centrally, not
peripherally.